Cefoxitin: An alternative to carbapenems in urinary tract infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae

Mambie, A.; Vuotto, Fanny; Poitrenaud, Delphine; Weyrich, Pierre; Cannesson, O.; Dessein, Rodrigue; Faure, Karine; Guery, Benoît; Galpérine, Tatiana

doi:10.1016/j.medmal.2016.04.008

Cited by 18 publications

(20 citation statements)

References 13 publications

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“…similar mortality rates (30.9% and 29.8%, respectively), and risk-adjusted mortality rate (OR 1.0, 95% CI; 0.45-2.17)[116]; the second study differentiated between empirical treatment (365 patients), directed treatment (601 patients) and overall cohort (627 patients), finding no differences in cure/improvement or 30-day mortality rate between carbapenem and BLBLI[117]. Although the number and quality of the clinical studies is very limited, cefoxitin has shown efficacy for the treatment of UTI caused by ESBL-producing strains[122]. A recent retrospective study with 69 patients with ESBL-producing BSI, in which 26 were treated with cefmetazole and 43 with carbapenems, showed an adequate efficacy of the cephamycin (1 death in the cefmetazole group and 5 deaths in the carbapenem group)[123].Other active antibiotics against ESBL-producing Enterobacteriaceae are aminoglycosides, colistin, fosfomycin, and tigecycline.…”

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confidence: 99%

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Aguado

Silva

Fernández‐Ruiz

et al. 2018

Transplantation Reviews

122

139

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Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection.

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mentioning

confidence: 99%

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Aguado

Silva

Fernández‐Ruiz

et al. 2018

Transplantation Reviews

122

139

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“…ESBL, extended-spectrum beta-lactamase; UTI, urinary tract infection. remains possible, maybe in a higher proportion for K. pneumoniae than E. coli isolates 6 despite the fact two different case series 12,13 reported no emergence of resistance with K. pneumoniae isolates in UTI. To answer this question, a plasma and tissue pharmacokinetics of FOX would be helpful.…”

Section: Discussionmentioning

confidence: 97%

Efficacy of cefoxitin for the treatment of urinary tract infection due to extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates

Sénard

Bouchand

Deconinck

et al. 2018

Therapeutic Advances in Infection

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Introduction:Cefoxitin has a good in vitro activity and stability in resistance to hydrolysis by extended-spectrum beta-lactamases and is a good candidate for the treatment of urinary tract infection. However, data are scarce regarding its use in clinical practice.Methods:We conducted a retrospective study from September 2014 to November 2017, in a tertiary care hospital in Garches (France). We gathered all prescriptions of cefoxitin for urinary tract infection due to extended-spectrum beta-lactamase isolates. We compared the clinical outcomes between Escherichia coli and Klebsiella pneumoniae extended-spectrum-beta-lactamase-producing isolates after a 90-day follow-up. When available, we assessed whether cefoxitin-based regimen was associated with an emergence of resistance.Results:The treatment of 31 patients with a mean age of 60 ± 18 years was analyzed. We observed a clinical cure of 96.7% (n = 30/31) at day 30 and of 81.2% (n = 13/16) and 85.7% (12/14) at day 90 for extended-spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae isolates, respectively (p = 0.72). No adverse events were reported. One patient who relapsed carried a Klebsiella pneumoniae isolate that became intermediate to cefoxitin in the follow-up.Conclusion:In a period of major threat with a continuous increase of extended-spectrum beta-lactamase obliging to a policy of carbapenem-sparing regimens, it seems detrimental to deprive physicians of using cefoxitin for extended-spectrum beta-lactamase Enterobacteriaceae for the treatment of urinary tract infection while our data show its efficacy.

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“…However in some recent studies, effectiveness of antibiotics other than carbapenems in the treatment of UTIs caused by ESBL-producing bacteria has been reported. [19,20] In another study, in patients with severe sepsis, and septic shock caused by resistant Gram-negative microorganisms, inappropriate initial empirical antibiotics was demonstrated to be related to mortality. In this study, as a source of sepsis, cases with UTI constituted 19.5% of all cases.…”

Section: Discussionmentioning

confidence: 99%

Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

Dökmetaş¹,

Hamidi²,

Bulut³

et al. 2017

Turkish Journal of Urology

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Objective: It has been shown in previous studies that inadequate empirical treatment is associated with mortality in a variety of infections caused by Gram-negative bacteria. In this study, the clinical effect of discordance in empirical treatment was investigated in patients with urinary tract infection (UTI) accompanied by bacteremia. Material and methods:We retrospectively reviewed the files of adult (>18 years old) patients who were diagnosed with UTI in our clinic between January 2014 and December 2015. Cases in which the same causative microorganism grew in both blood and urine cultures were included in the study. Patients using ceftriaxone and carbapenem as empirical antibiotic therapy (EAT) were compared as two different groups. In cases that the ethiologic agents were extended-spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae and Escherichia coli isolates, if the microorganism was resistant to initial antibiotic treatment the situation was defined as EAT discordance, and if it was sensitive it was defined as EAT concordance. Results:After the exclusion criteria were applied, 65 of the 266 cases examined were taken into the study. Clinical and laboratory features of cases of ceftriaxone and carbapenem groups were similar. There was no statistically significant difference between the two groups in terms of hospital stay and survival (p>0.05). Of 28 cases of ESBL-producing E. coli and K. pneumoniae, 18 were EAT discordant and 10 were EAT concordant. Clinical and laboratory features of EAT concordant and EAT discordant groups were similar. No statistically significant difference was found between the two groups in terms of hospital stay and survival (p>0.05). Conclusion:It was considered that ceftriaxone can still be a viable option in the EAT of UTI, which is accompanied by bacteremia without severe sepsis and septic shock findings. It was concluded that EAT discordance may not have a negative effect on the duration of hospital stay and survival rates in neither total cases nor ESBL positive ones.Keywords: Bacteremia; empirical antibiotic therapy; urinary tract infection.Cite this article as: Dökmetaş İ, Hamidi AA, Bulut ME, Çetin S, Öncül A, Uzun N. Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia. Turk J Urol 2017; 43(4): 543-8.

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Cefoxitin: An alternative to carbapenems in urinary tract infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae

Cited by 18 publications

References 13 publications

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations

Efficacy of cefoxitin for the treatment of urinary tract infection due to extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates

Clinical effect of discordance in empirical treatment of cases with urinary tract infection accompanied by bacteremia

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